Healthcare Provider Details

I. General information

NPI: 1922585462
Provider Name (Legal Business Name): BANIS GITHINJI FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2018
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 IVY LN STE 414
GREENBELT MD
20770-6357
US

IV. Provider business mailing address

6301 IVY LN STE 414
GREENBELT MD
20770-6357
US

V. Phone/Fax

Practice location:
  • Phone: 240-575-0437
  • Fax:
Mailing address:
  • Phone: 240-930-7466
  • Fax: 240-692-0126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR213835
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: